Provider Demographics
NPI:1598860686
Name:LEMCKE, DAWN P (MD)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:P
Last Name:LEMCKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 31235
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85751-1235
Mailing Address - Country:US
Mailing Address - Phone:520-324-4780
Mailing Address - Fax:520-324-1406
Practice Address - Street 1:7510 N ORACLE RD
Practice Address - Street 2:UNIT 100
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704
Practice Address - Country:US
Practice Address - Phone:520-324-4910
Practice Address - Fax:520-324-4911
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ24759207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ367096Medicaid
AZ139912Medicare PIN
AZ367096Medicaid
AZZ199707Medicare PIN